Peripheral Artery Disease Common, Manageable

“Anything that increases
the risk of plaque
buildup in the blood
vessels can increase
the risk of PAD
,” Dr. Muppala says.

Peripheral artery disease, or PAD, is a common circulatory problem that affects more
than 12 million people in this country. Caused by atherosclerosis the buildup of
plaque in the arteries PAD affects the blood vessels of the lower extremities.
Interventional cardiologist Murali Muppala, M.D., says that the risk factors for PAD
are similar to those for coronary artery disease and the condition is most common in
people age 50 and older. Anything that increases the risk of plaque buildup in
the blood vessels can increase the risk of PAD, Dr. Muppala says.

Specific risk factors include:

Increase in low-density lipoprotein
(LDL) bad cholesterol and
triglycerides and a decrease in highdensity
lipoprotein (HDL) good
cholesterol

Smoking

Diabetes
Hypertension high blood pressure

Family history

Obesity

Lack of exercise

Chronic kidney failure

Dr. Muppala says 50 percent of people with PAD do not experience symptoms, but if
and when they do, they can include leg cramping and heaviness with activity that gets
better with rest.

Other common symptoms include:

Hair loss

Numbness in the legs

Legs feeling cold

Loss of calf muscle mass

Change in color with elevation or
dangling of legs

Painful ulcers in the toes

Diagnosis can be done by a simple physical examination or a noninvasive test, like
ankle-brachial index (ABI), which compares the blood pressure between the arm
and the affected leg. Other noninvasive tests include ultrasound, CT and magnetic
resonance angiogram (MRA). Angiography is the gold standard for diagnosis, Dr.
Muppala says.

Using small plastic tubes inserted in the groin, we inject iodine contrast
into the blood vessels, which allows us to view the blood flowing through the arteries.
There is a wide range of treatment options for PAD, says general and vascular surgeon
John Moss, D.O.

Less invasive options may be available, like supervised walking programs and lifestyle
modification like smoking cessation, weight reduction and controlling diabetes,
high blood pressure and cholesterol, Dr. Moss says. There also are medications that
improve blood flow. Other, more invasive treatment options include removing plaque
from the arteries, angioplasty or bypass surgery.

PAD is a lifelong condition that requires the medical management of underlying risk
factors, lifestyle modification and the coordination of care from specialized physicians.